Impact of climate change could become serious public health problem for southern Africa
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Nearly 20 years ago, the World Health Organisation (WHO) conducted a study that measured the impact of climate change on worldwide human health.
The health impact of four climate-sensitive health effects - diarrhoea, malaria, health effects from inland and coastal flooding and malnutrition - were modelled and compared to figures taken from 1990.
"Southern Africa was found to be the region with the highest mortality rates from climate change in the period studied," writes Professor Rebecca Garland, principal researcher of the climate studies modelling and environmental health research group at the Council for Scientific and Industrial Research (CSIR).
The WHO study only looked at a partial list of health impacts. "However, the high impact of climate change on southern Africa still indicates a potentially serious public health problem, a fact that could additional pressures to public health services within the region.
"Since many of the potential health impacts are not new issues to the area, but rather issues that the region has been struggling with for quite some time, it's important to start developing plans and systems that will effectively protect the public's health from these health impacts," she notes.
Garland's report is contained in the second edition of the South African Risk and Vulnerability Atlas, developed by scientists at the CSIR, an entity of the Department of Science and Technology.
The document, says the CSIR, was drafted to help the country’s economic and social sectors take informed decisions to avoid risks related to climate change.
"South Africa is facing an increased frequency of extreme weather events such as droughts, dry spells, heat waves and severe thunderstorms," says the CSIR. "These have the potential to increase vector-borne diseases and lead to food, energy and water insecurity, which will consequently threaten livelihoods."
Garland writes how Africa has already seen warming and "it is likely that temperature increases over this continent will increase at a rate faster than the projected increase of global temperatures. These increasing temperatures have the potential to negatively affect human health in the future."
Public health in SA is "in a unique situation with a quadruple burden of disease, with HIV/Aids, communicable diseases, non-communicable diseases and injuries all contributing to this burden.
"This quadruple burden also puts a stress on the public health sector and climate change could add an additional stressor to this sector."
Exposure to high ambient temperatures, including those experienced during heatwaves, has been associated with increases in mortality from heatstroke, cardiovascular, cerebrovascular and or respiratory diseases, writes Garland.
That's why she says it's critical for decision-makers and health stakeholders to understand the health risks involved and start to develop appropriate planning, managing and easing efforts to lessen the future health impacts brought on by increasing temperatures.
Increasing temperatures could lead to people being exposed to higher temperatures. "If the health sector has an early warning system and heat-health action place in place that could help people respond quickly in setting up preventative and response measures, the health impacts from exposure to high temperatures may be decreased.
"However, if health systems are not prepared for high temperature events and the systems become overwhelmed, the impacts may be worsened."
Climate change may affect water availability or quality, which in turn, can have various impacts on health.
"If every person in SA has continuous access to water that is clean and safe to drink and in the quantities needed, the health impacts from water-borne diseases, such as cholera can be greatly minimised.
"However the opposite is also true. If people do not access to water that is clean and safe to drink, the health impact from deteriorating water quality from climate change will be worsened."
The CSIR says it is critically important for planners and decision-makers to move from "reactive crisis management approaches" to proactive climate change and disaster risk management approaches..
"According to the Financial and Fiscal Commission report, the 20 most vulnerable municipalities in South Africa are rural, small towns and secondary cities. Their vulnerabilities are expected to increase due to the high levels of informal housing and the lack of efficient management of these growth areas. "Rural areas are particularly vulnerable due to their dependency on climate-sensitive resources such as water and an agrarian landscape."
Southern Africa, and the entire continent, is highly vulnerable to the consequences of climate change, writes Garland.
"Projections highlight that sub-tropical northern and sub-tropical southern Africa are expected to see the largest increases in maximum temperature and are 'hot spots' for increases in heatwave days.
"The large potential impact means that vulnerability assessments of communities in SA are key - not only to understand who is vulnerable to what health impacts but also what is making them vulnerable and what role modifying factors play in this vulnerability."
The Department of Health, says Garland, has developed a National Climate Change and Health Adaptation Plan 2014-2019, which identified heat stress, natural disasters, housing and settlements, communicable diseases, exposure to air pollution and respiratory diseases, non-communicable diseases, vector and rodent-borne diseases, food insecurity, hunger and malnutrition and mental health.
"The list focuses on public health, although occupational health (heat stress in outdoor workers, mine workers, agricultural workers) may also be impacted by a changing climate, making it another important consideration."
Many countries have implemented planning measures, such as heat warnings and heat-health plans, to help prevent increases in morbidity and mortality from high temperature events.
In Philadelphia, she writes how there are 10 activities enacted once a warning has been issued by the US National Weather Service, including media announcements, halting suspensions of utility services and increasing in emergency medical service staffing.
"Even though research is ongoing, to protect human health, key stakeholders can still develop draft heat health action plans.
"For example, government and local authorities can still develop plans to educate the public and businesses on what to do when temperatures are high (reduce physical activity, especially in the middle of the day, drink plenty of fluids) and medical services can develop plans to ensure the increased provision of services when hot temperatures are forecasted."